Your Information. Your Rights. Our Responsibilities.
This notice explains your rights and our responsibilities related to nondiscrimination and equal access to care. Please review it carefully.
Legacy Dental Professionals complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Legacy Dental Professionals does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
You have the right to:
Receive care and services without discrimination
Request reasonable accommodations for a disability
Request free communication assistance (such as qualified interpreters or written materials in alternative formats)
Request free language assistance if your primary language is not English
File a grievance if you believe you have been discriminated against
File a civil rights complaint with the U.S. Department of Health and Human Services (HHS), Office for Civil Rights
Legacy Dental Professionals provides free aids and services to people with disabilities to communicate effectively with us, such as:
Qualified sign language interpreters
Written information in other formats (large print, audio, accessible electronic formats)
Other reasonable accommodations when needed
Legacy Dental Professionals provides free language services to people whose primary language is not English, such as:
Qualified interpreters
Information written in other languages
If you need these services, contact us at (586) 731-8338.
If you believe Legacy Dental Professionals has failed to provide these services or discriminated in another way, you may file a grievance by contacting:
Legacy Dental Professionals
7777 25 Mile Rd.
Shelby Township, MI 48316
Phone: (586) 731-8338
Email: [info@legacydentalprofessionals.com]
You can file a grievance in person, by mail, fax, or email. We will respond within a reasonable timeframe.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:
Online: HHS OCR Complaint Portal
Mail: 200 Independence Avenue, S.W., Room 509F, HHH Building, Washington, D.C. 20201
Phone: 1-800-368-1019 (TTY: 1-800-537-7697)
Legacy Dental Professionals may update this notice from time to time. The current version will be available upon request in our office and posted on our website.
